Health and illness beliefs regarding pain and pain management of New Zealand resident Samoan community leaders: A qualitative interpretive study based on Pasifika paradigms.

ISSUE ADDRESSED: Ethnic disparities in chronic pain exist in Aotearoa New Zealand, including a greater impact of pain, less access to chronic pain services and less benefit from treatment for Pasifika people. This study investigated Samoan health perceptions and beliefs in relation to pain and how it is managed. METHODS: An interpretive descriptive study was undertaken involving interviews with nine Samoan key informants from Aotearoa New Zealand. Interviews explored their beliefs in relation to interpretations of pain and experiences of and preferences for pain management. Interviews were recorded and transcribed. Data were analysed using thematic analysis. RESULTS: Four main themes were constructed from the data. Pain is interpreted holistically described the attribution of pain to many causes, without limitation to physiological explanations. Stoicism is a character virtue described the predominant belief that pain should be endured without display or complaint. Strength in connectivity described the inherent pain coping strategies that are present within Samoan communities. To improve healthcare is to nurture va described the disconnect Samoan people feel from healthcare services and the need to foster relationships to improve health delivery. CONCLUSIONS: Samoan people have beliefs and perceptions about pain and its management that extend beyond traditional Western interpretations. While pain is often endured using traditional strengths within the 'aiga (family) and community, the Samoan community faces challenges in receiving healthcare from mainstream pain services. SO WHAT?: Clinicians need to foster stronger relationships with Samoan individuals and their 'aiga and appreciate the wider psychosocial context of pain, including spirituality.

Cultural Differences in Psychological Distress and Illness Perceptions Amongst People Living With Cardiac Inherited Diseases.

Cardiac Inherited diseases (CID) and minority ethnic status are both associated with anxiety and depression. This study aimed to investigate differences in patient experiences of CID between ethnic groups in New Zealand (NZ) in order to inform psychosocial interventions and promote health equity. A cross-sectional survey was administered to a NZ CID database. One-hundred and fifty-two (152) NZ Europeans, 19 Maori, and two Pasifika participated. Maori and Pasifika peoples reported significantly greater symptom perceptions, shorter timeline perceptions, higher perceived risk of severe symptoms, and were less likely to attribute the cause of their CID to hereditary factors than NZ Europeans. Maori and Pasifika also reported more anxiety and distress, although both groups reported beneficial medication perceptions and high medication adherence. Differences could not be attributed to clinical or other demographic variables. The use of screening tools and development of culturally appropriate interventions may help reduce both distress and health inequities.

Perspectives and experiences of Maori and Pasifika peoples living with cardiac inherited disease: a qualitative study.

OBJECTIVE: Cardiac inherited diseases can have considerable psychosocial effects, including lifestyle limitations, anxiety and depression. Most research to date on patient experiences of CID has been conducted with people from Western cultures, yet culture can shape patient views and experiences of health. The aim of this research was to explore the experiences and perspectives of Maori and Pasifika living with a cardiac inherited disease (CID). METHODS AND MEASURES: Semi-structured interviews were conducted with 14 Maori and 14 Pasifika patients living with a cardiac inherited disease and seven of their family members, using Talanoa and Kaupapa Maori methodologies. Themes from the interviews were identified using interpretative phenomenological analysis. RESULTS: Three common themes were identified as important in shaping participants' perceptions and experiences of CID: (1) difficulty in understanding the disease as separate from symptoms, (2) considering ancestors and future generations and (3) the role of spirituality and religion. CONCLUSION: This study highlights a gap between indigenous patients' understanding of CID and the western biomedical approach. Patients' understanding and treatment behaviours depend on symptoms, familial ties and spirituality. The findings support the need for transparency and culturally appropriate practices in healthcare. Considering these aspects may help to reduce health inequities for these populations.